Finding new therapeutic uses for existing medicines could lead to safe, affordable and timely new treatment options for patients with high medical needs. However, due to a lack of economic incentives, pharmaceutical developers are rarely interested to invest in research with approved medicines.

Approved medicines, especially when they are out of basic patent or regulatory protection, are not within the scope of research funded by the pharmaceutical industry. Potential new uses for these medicines are mainly studied in independent clinical trials initiated and led by researchers from academia, research institutes, or collaborative groups. Lack of sufficient financial support to conduct expensive phase III clinical trials limits their effort to exploratory research, without generating the necessary evidence to confirm promising findings.

In this study, scientific and grey literature was searched to identify and evaluate new mechanisms for funding clinical trials with repurposed medicines. Semi-structured interviews were also conducted with stakeholders with expertise in clinical research, funding mechanisms and/or drug repurposing.

The results reveal that it is clear that there is a need for increased harmonisation and centralisation of clinical research and funding at the European and international level in order to reduce fragmentation and maximise the value of limited resources.